WEBVTT - Karol Markowicz Show: Going Menopostal with Amy Alkon 0:00:03.520 --> 0:00:07.200 Hi, and welcome back to the Karl Marco Show on iHeartRadio. 0:00:07.800 --> 0:00:11.239 I'm going to take a break from monologues for a bit. 0:00:11.920 --> 0:00:14.720 I know people like them and I like doing them, 0:00:15.400 --> 0:00:19.520 but I feel like they're a little disorganized and they're 0:00:19.600 --> 0:00:22.880 just about whatever I'm thinking that day. And I know 0:00:22.960 --> 0:00:26.480 that that is maybe part of their appeal. They're kind 0:00:26.480 --> 0:00:29.280 of spontaneous. It's like I saw this, or I was 0:00:29.320 --> 0:00:32.519 thinking this, or I read this. But I want to 0:00:32.560 --> 0:00:36.800 make them a little more cohesive. I want to jump 0:00:36.840 --> 0:00:41.280 around from topic to topic less and I want to 0:00:41.360 --> 0:00:45.680 have a wider point. I'm almost at the two year 0:00:45.800 --> 0:00:49.000 mark of this podcast, and I've learned a lot since 0:00:49.000 --> 0:00:54.120 I started. I love my listeners and I respect your time, 0:00:54.520 --> 0:00:58.480 so I want to spend this summer figuring out how 0:00:58.480 --> 0:01:02.920 to make the monologues less jumpy and more coherent so 0:01:02.960 --> 0:01:06.600 that my listeners get more out of them. I'd love 0:01:06.680 --> 0:01:09.120 to hear from you all about what you'd like the 0:01:09.200 --> 0:01:13.280 monologues to be going forward, or anything else you'd like 0:01:13.360 --> 0:01:17.880 to tell me at Carol Markowitz Show at gmail dot com. 0:01:18.600 --> 0:01:21.319 I'd love to hear from you. Please let me know 0:01:21.440 --> 0:01:25.520 how your summer's going. Thanks for listening coming up my 0:01:25.640 --> 0:01:30.120 interview with Amy Alkin. But first, folks, we're seeing something 0:01:30.200 --> 0:01:34.959 truly disturbing. 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Visit IFCJ dot org or call eight eight 0:03:05.639 --> 0:03:08.679 eight for eight eight IFCJ. 0:03:09.160 --> 0:03:15.720 Now, welcome back to the Carol Markowitz Show on iHeartRadio. 0:03:16.200 --> 0:03:20.400 My guest today is Amy Alcon, an award winning investigative 0:03:20.480 --> 0:03:24.960 science writer who specializes in science help, using scientific evidence 0:03:25.040 --> 0:03:28.760 to solve real world problems. Amy's new book is called 0:03:28.840 --> 0:03:32.240 Going Menopostal What you and your doctor need to Know 0:03:32.320 --> 0:03:35.640 about the real science of menopause and Perimenopause. 0:03:35.720 --> 0:03:35.920 Hi. 0:03:36.000 --> 0:03:37.640 Amy's so nice to be have you on. 0:03:38.240 --> 0:03:39.760 This is great, Come on, thank you. 0:03:40.320 --> 0:03:43.160 I'm a longtime fan. As you know, I have read 0:03:43.200 --> 0:03:46.360 your previous books. I'm extremely excited to read this one. 0:03:46.800 --> 0:03:50.640 Your new book is a serious look at menopause and 0:03:50.760 --> 0:03:54.880 perimenopause and the way that it's often ignored by doctors 0:03:54.920 --> 0:03:55.800 and researchers. 0:03:56.200 --> 0:03:59.520 So why is that? Is it just sexism? 0:03:59.840 --> 0:04:01.880 No, No, it's not sexism at all. Many of the 0:04:01.880 --> 0:04:06.400 researchers are women. The problem is that, first of all, 0:04:06.480 --> 0:04:10.040 it's there's a whole medicine wide problem that our medicine 0:04:10.080 --> 0:04:12.760 is not really evidence based, and people find this really 0:04:12.760 --> 0:04:15.320 hard to believe. But there are three big myths about 0:04:15.320 --> 0:04:18.120 our medical care. One is that doctors are able to 0:04:18.160 --> 0:04:21.840 read science and make decisions based in science. They're actually 0:04:21.880 --> 0:04:25.840 not taught to read science in med school. Med schools 0:04:25.839 --> 0:04:28.680 and medical institutions are so at fault here. You know, 0:04:28.720 --> 0:04:31.600 people think, oh, you're going to bash doctors. I don't. Actually, 0:04:32.040 --> 0:04:37.000 this is the responsibility of med schools and providers to provide. 0:04:37.080 --> 0:04:39.760 If the doctors aren't trained in science, someone needs to 0:04:39.760 --> 0:04:43.599 be there, you know, nerds to you know, say okay, 0:04:43.640 --> 0:04:46.839 here's what the science says, and to generate practice standards, 0:04:47.040 --> 0:04:49.480 which are the guidelines doctors go by to treat you. 0:04:50.040 --> 0:04:52.120 And then the other the other two myths of that 0:04:52.160 --> 0:04:55.520 doctors are trained in diagnostic reasoning. I'll a doctor house. 0:04:55.560 --> 0:04:56.760 If anyone's seen that show. 0:04:57.040 --> 0:04:57.440 I love it. 0:04:57.839 --> 0:05:00.200 I have never watched it, but I watch them. The 0:05:00.240 --> 0:05:03.320 clips of it now are going viral again for some reason. 0:05:03.839 --> 0:05:06.919 Well, they do this differential diagnosis where they look to 0:05:07.400 --> 0:05:11.040 see what is the underlying condition causing your symptoms and 0:05:11.080 --> 0:05:13.960 what doctors do. This is a big medical error. They 0:05:14.000 --> 0:05:17.480 will treat your symptoms without looking for the underlying disorder. 0:05:17.839 --> 0:05:20.560 So if you have a headache, you know, maybe you 0:05:20.680 --> 0:05:23.880 just are stressed out and you need some whatever tile 0:05:23.920 --> 0:05:26.440 it all, or maybe you have a brain tumor. Now 0:05:26.480 --> 0:05:29.840 if we cure your headache, we've lost an important signal. 0:05:29.960 --> 0:05:33.240 So it's vital that we look for underlying conditions. And 0:05:33.279 --> 0:05:36.279 then the third one is that doctors, this is so horrible. 0:05:36.520 --> 0:05:41.200 They are not trained to correctly assess risk. So they 0:05:41.240 --> 0:05:43.360 can't tell you what's my risk of this or that 0:05:43.880 --> 0:05:47.600 they either will not get it right or they rely 0:05:47.760 --> 0:05:55.640 on these overblown pharmaceutical company rep percentages that are actually 0:05:55.040 --> 0:05:59.680 not meaningful to individuals at all. Their comparisons of one 0:05:59.680 --> 0:06:03.000 group to another. So when they say like fifty percent 0:06:03.160 --> 0:06:07.400 less risk, well that might be you know, it's a 0:06:07.480 --> 0:06:10.760 very small number. You know, it's not your risk, it's 0:06:10.880 --> 0:06:13.360 just this group to the other one. And so these 0:06:13.400 --> 0:06:16.359 are huge problems. And then there's a scandal in gynecology 0:06:16.640 --> 0:06:20.960 that people don't know about. So in gynecology, almost no 0:06:21.279 --> 0:06:25.560 doctors have any training, not even an hour of training 0:06:25.800 --> 0:06:32.560 in menopause or perimenopause science, right because they it's medical education, 0:06:32.760 --> 0:06:36.560 medical education is so terrible. These schools are lazy. There's 0:06:36.600 --> 0:06:40.400 no reason to change them because they're just dodgy bureaucrats 0:06:40.440 --> 0:06:44.200 who run them, you know, taking in the donation dollars, 0:06:44.600 --> 0:06:48.800 and why start these programs in diagnostic reasoning and proper 0:06:48.880 --> 0:06:52.760 risk assessment? These cost money, These require change. New hires 0:06:53.040 --> 0:06:56.400 will just do what we're doing. And this is horrible. 0:06:56.920 --> 0:06:59.960 This is horrible because the father of evidence based medical 0:07:00.240 --> 0:07:03.000 David Sackett, said, fifty percent of what you learn in 0:07:03.000 --> 0:07:06.039 med school will be wrong. The problem is we don't 0:07:06.080 --> 0:07:09.720 know which fifty percent, and it changes. The medicine changes 0:07:09.840 --> 0:07:13.680 so quickly. Now, so doctors. They when you go to 0:07:13.720 --> 0:07:16.240 the doctor, they treat you. They will send you guide 0:07:16.240 --> 0:07:19.600 ecology departments will send you to a baby doctor. Doctors 0:07:19.600 --> 0:07:23.240 who are maternity specialists, and those doctors are made to 0:07:23.320 --> 0:07:26.400 treat you in something they have zero training and expertise. 0:07:26.840 --> 0:07:30.560 And this is medically unethical. This is unethical. They should. 0:07:30.880 --> 0:07:33.280 I write about this in the book by a cardiologist 0:07:34.000 --> 0:07:36.480 I think her name is Sarah Holland she said, you know, 0:07:37.360 --> 0:07:40.840 she's doing these massive cardiovascular operations. And she said, if 0:07:40.840 --> 0:07:44.440 my patient wants me to prescribe allergy medicine. I apologize 0:07:44.680 --> 0:07:46.640 and say, I know it would be more convenient, but 0:07:46.760 --> 0:07:49.840 I don't know that area. She might prescribe the wrong thing. 0:07:50.360 --> 0:07:53.640 And so because of this, doctors, you go to your 0:07:53.720 --> 0:07:57.720 doctor with perimenopausal symptoms, you know, and the doctor doesn't 0:07:57.760 --> 0:08:01.400 know what they are, dismisses you, norse the symptoms, doesn't 0:08:01.440 --> 0:08:06.080 treat you or mistreats you. Doctors will give patience antidepressants. 0:08:06.480 --> 0:08:09.240 This is terrible. I think people have been reading in 0:08:09.280 --> 0:08:12.320 the news. You know, there are great tapering problems for people, 0:08:12.600 --> 0:08:16.360 and what they don't do. They might antidepressants can bring 0:08:16.440 --> 0:08:21.600 down hot flashes, but they don't. They don't solve all 0:08:21.640 --> 0:08:27.240 these problems that you have and unhealth underlying unhealth in perimenopause, 0:08:28.200 --> 0:08:33.040 for example, your bones. They don't protect your bones the 0:08:33.080 --> 0:08:37.040 way our natural hormones do. And what doctors don't know 0:08:37.160 --> 0:08:40.640 the cause of great suffering during perimenopause. And I should 0:08:40.720 --> 0:08:43.520 name some of the symptoms so women get hot flashes. 0:08:43.800 --> 0:08:45.959 This is how I started the book. I was sitting here. 0:08:45.960 --> 0:08:48.160 I live in Venice, California. This is like the most 0:08:48.160 --> 0:08:51.400 temperate place in the world. You know, It's breezy summer day, 0:08:51.440 --> 0:08:53.319 and all of a sudden. I'm sitting here at my 0:08:53.400 --> 0:08:56.040 desk and I'm sure. I'm like, why do I feel 0:08:56.040 --> 0:08:59.240 like I'm locked in a trunk in the everplace? He's crazy? 0:08:59.440 --> 0:09:02.400 I thought, oh my god, I hot flash. And you know, 0:09:02.440 --> 0:09:05.239 you want to go to your doctor and say, I'm uncomfortable. 0:09:05.280 --> 0:09:08.319 What should I do? But I know better. I've been 0:09:08.360 --> 0:09:11.040 coached since around two thousand and seven by this very 0:09:11.160 --> 0:09:16.079 generous epidemiologist and biostatistician, Sander Greenland. He's a co author 0:09:16.120 --> 0:09:19.920 of the seminal book in the field, and he has 0:09:20.240 --> 0:09:24.680 helped me learn how to critically evaluate research and look 0:09:24.679 --> 0:09:28.520 and see if the methodology is adequate. All studies are flawed, 0:09:28.920 --> 0:09:31.559 but are they so flawed that you cannot you know 0:09:31.600 --> 0:09:34.240 that they're not conclusive about anything, and you look for 0:09:34.280 --> 0:09:36.640 a body of work. You don't just go buy one study. 0:09:36.640 --> 0:09:39.160 This is a problem where people say, oh, do your 0:09:39.200 --> 0:09:41.800 own research. Well, you have to know what to look at, 0:09:41.800 --> 0:09:43.520 and you have to look at a great deal of 0:09:43.559 --> 0:09:47.040 research to know you know where, you need to know 0:09:47.080 --> 0:09:50.000 the whole landscape. So all of this is so terrible, 0:09:50.000 --> 0:09:52.440 So you go to your doctor. I oh, so sorry, 0:09:52.440 --> 0:09:56.440 I cut off my story. Basically, I started doing this 0:09:56.520 --> 0:10:00.720 deep dive into the research to figure out what the sciences, 0:10:00.720 --> 0:10:05.520 and I saw this just massive gap between the practice standards. 0:10:06.120 --> 0:10:08.880 These are the standards for treating you, the guidelines for 0:10:08.960 --> 0:10:11.160 treating you that these doctors, I mean, they just read 0:10:11.200 --> 0:10:15.000 them off a list because they don't know themselves, no training, 0:10:15.080 --> 0:10:17.679 and they're victims in this. It is horrible to expect 0:10:17.679 --> 0:10:19.520 a doctor to do this. And this is you know, 0:10:19.600 --> 0:10:21.959 status quo in these departments. So people don't say no, 0:10:22.160 --> 0:10:24.079 they want to keep their jobs. They just get there. 0:10:24.160 --> 0:10:27.240 They're young and new, so they just okay, do the 0:10:27.240 --> 0:10:31.199 best I can. That's horrible. That's horrible, you know, And 0:10:31.280 --> 0:10:35.160 so they don't have any ability to really know what's 0:10:35.200 --> 0:10:38.200 going on with you. And so women are left with 0:10:38.240 --> 0:10:40.760 these symptoms and some of them. One of the things 0:10:40.840 --> 0:10:44.720 I went through a horrible perimenopause. Now perimenopause, I should say, 0:10:45.000 --> 0:10:48.440 is that transition period to menopause, three to ten years 0:10:48.840 --> 0:10:52.760 leading up to menopause, when your hormones start to go 0:10:52.840 --> 0:10:56.400 whack out basically, and what people don't know, what doctors 0:10:56.440 --> 0:11:00.920 don't know, they think that perimenopause is this menopause light 0:11:01.480 --> 0:11:02.600 that your estrogen. 0:11:02.640 --> 0:11:04.000 That's what I really thought it was. 0:11:04.240 --> 0:11:06.520 Yeah, I did too. Believe me, all these things I 0:11:06.559 --> 0:11:09.640 was disabused on when I read the science. What actually 0:11:09.800 --> 0:11:14.120 happens is that your estrogen spikes and dives and this 0:11:14.200 --> 0:11:17.480 causes a release of stress hormones. This is the most 0:11:17.520 --> 0:11:20.160 horrible thing. And then if you don't have the second 0:11:20.160 --> 0:11:25.160 hormone of the menstrual cycle, estrogen's partner, progesterone, being made, 0:11:25.520 --> 0:11:28.040 you can get really sick, which is what happened to me. 0:11:28.720 --> 0:11:32.280 And the reason progesterone is not made in perimenopause is 0:11:32.280 --> 0:11:35.640 that not all of our cycles are ovulatory. This is 0:11:35.679 --> 0:11:38.640 one third throader throughout our lives. And this is all 0:11:38.800 --> 0:11:41.680 the stuff on progesterone and perimenopause comes from the research 0:11:41.760 --> 0:11:44.679 of Geraln. Pryor, who is this fierce woman who grew 0:11:44.760 --> 0:11:48.439 up in Alaska with no running water electricity, daughter of missionaries, 0:11:48.679 --> 0:11:52.199 and brings that fierceness to science. She's an enochronologist and 0:11:52.280 --> 0:11:55.280 has tried to put perimenopause on the map for its 0:11:55.360 --> 0:11:59.280 unique hormonal state, and also have progesterone research, which is 0:11:59.360 --> 0:12:03.280 very important. So progesterone is made when you ovulate, when 0:12:03.280 --> 0:12:08.200 the little eggsaft ruptures and the egg is released. So 0:12:08.480 --> 0:12:12.680 but in perimenopause and then sometimes before you don't have ovulation. 0:12:12.760 --> 0:12:14.760 You know, normal, you have a normal period. It doesn't 0:12:14.800 --> 0:12:18.080 seem any different, but there's no eggsact rupture. And what 0:12:18.200 --> 0:12:21.800 happens that is that you don't have progesterone made because 0:12:21.800 --> 0:12:24.720 it's makes the litter that's left behind called the corpus lute, 0:12:24.920 --> 0:12:27.360 this yellow waxy stuff. And then you have a you 0:12:27.400 --> 0:12:30.440 have days of progesterone, you know where you if you 0:12:30.520 --> 0:12:33.679 have an adequate number where you progest your own you know, 0:12:33.760 --> 0:12:37.960 from the ovulation, then you are protected, your bones are protected, 0:12:38.520 --> 0:12:41.640 You're able to sleep, which I lost. This insomni is 0:12:41.679 --> 0:12:43.320 a huge thing. Yeah, and you're not. 0:12:43.400 --> 0:12:46.559 Insomnia is actually I would say, I'm I'm in my 0:12:46.720 --> 0:12:51.480 late forties. The sleeplessness is the only like symptom that 0:12:51.520 --> 0:12:55.080 I recognize right now. But even going to the doctor 0:12:55.120 --> 0:12:58.120 for that, it's very like, well, you know, maybe wear 0:12:58.160 --> 0:12:59.960 yourself out more, go on more water. 0:13:00.880 --> 0:13:03.880 I'm like, no, no, I have My sleep is not. 0:13:04.280 --> 0:13:07.480 I was an amazing sleeper. I was a champion sleeper, 0:13:07.600 --> 0:13:11.439 and now I've gotten to where, you know, I definitely 0:13:11.480 --> 0:13:16.400 have an issue, and it's it's clearly because I'm heading 0:13:16.480 --> 0:13:21.040 in the minopousal menopausal direction. Like you say, doctors just 0:13:21.120 --> 0:13:22.360 don't know what to do about it. 0:13:22.640 --> 0:13:24.440 So this is what's so important. This is what I 0:13:24.440 --> 0:13:28.520 did with this book, going menapostal. What I do. Medicine 0:13:28.600 --> 0:13:31.800 is not going to change doctors institutions. They are not 0:13:31.840 --> 0:13:34.880 going to be evans based overnight. But we need care 0:13:35.000 --> 0:13:37.840 now that is evidence based. So what I do is 0:13:37.880 --> 0:13:41.559 I bring the evidence to all of us in ordinary language. 0:13:41.559 --> 0:13:43.880 I have right over there on my router. Write every 0:13:43.920 --> 0:13:46.600 page of this book for Pamela d. That is a 0:13:46.640 --> 0:13:48.880 note to myself to not be a jerk or you know, 0:13:48.920 --> 0:13:52.000 write things to show like how smart I am. Right, 0:13:52.559 --> 0:13:56.439 we don't care. Write it in the most accessible, understandable 0:13:56.520 --> 0:13:58.960 language because it's hard stuffed. And I also put in 0:13:58.960 --> 0:14:02.480 all this humor because you cannot read a book like this. 0:14:02.480 --> 0:14:06.240 It's terrifying stuff without having these vacations. Right, and so 0:14:07.240 --> 0:14:10.959 with the sleep thing, what's really important is to do 0:14:11.920 --> 0:14:18.160 this quantitative basil temperature testing. Now people test their more 0:14:18.240 --> 0:14:21.320 first morning temperature to see if they're ovulating. Now, the 0:14:21.360 --> 0:14:23.800 book contains this horrible fact that we do not have 0:14:23.840 --> 0:14:26.720 a twenty day menstrual cycle. This is wrong. Some women 0:14:26.880 --> 0:14:29.760 have much longer ones or shorter ones. And these all 0:14:29.800 --> 0:14:33.080 of these ovulation apps, I mean, they're leading women who 0:14:33.120 --> 0:14:36.160 are expecting to know when they're fertile with the wrong information. 0:14:36.160 --> 0:14:40.240 It's really horrible. But what is effective is measuring your 0:14:40.320 --> 0:14:45.560 first morning temperature through this quantitative basil temperature taking. And 0:14:45.600 --> 0:14:48.080 then what happens is and this is a bit detailed, 0:14:48.080 --> 0:14:50.000 so you can look this up in the book, but 0:14:50.640 --> 0:14:53.120 you want to see if you have enough days where 0:14:53.120 --> 0:14:57.720 you're having progesterone and it's indicated by temperature rise that 0:14:57.800 --> 0:15:02.359 you are protected, that you have this really important protective hormone. 0:15:02.520 --> 0:15:05.520 And because I didn't, and you know, I didn't have 0:15:05.640 --> 0:15:10.480 enough progesterone, I wasn't I wasn't ovulating. My sleep was 0:15:10.560 --> 0:15:13.600 so horrible. I had terrible brain fog. I was waking 0:15:13.680 --> 0:15:17.640 up like you. I mean I never champion. Yes, like 0:15:17.680 --> 0:15:20.680 someone hit me with a large frying pan. And then 0:15:22.080 --> 0:15:24.600 and this was like this, I mean, now I lay 0:15:24.640 --> 0:15:27.280 me down to thrash five or six times a night. 0:15:27.560 --> 0:15:30.920 The torture. I tried every hot, showers, cold, I mean, 0:15:31.440 --> 0:15:33.480 do my feet need to be colder? It was like 0:15:33.520 --> 0:15:37.000 all this voodoo, you know, and so yeah, science in 0:15:37.080 --> 0:15:40.160 this I realized I needed progesterone, and I had to 0:15:40.200 --> 0:15:44.680 fight three battles with TiSER Permanente, my medical provider, to 0:15:44.880 --> 0:15:48.200 get the progesterone, to get the amount I need, which 0:15:48.240 --> 0:15:50.040 they do not give you in America. They don't give 0:15:50.040 --> 0:15:52.560 you an amount protective of the endometrium, which is three 0:15:52.640 --> 0:15:57.720 hundred milligrams of oral micronized progesterone per night, and then 0:15:57.760 --> 0:16:00.960 to get it covered, you know, and I should say 0:16:01.040 --> 0:16:04.000 my ecologist, he was wonderful. I have a male you know, 0:16:04.480 --> 0:16:07.240 not like one of those patients like if you're my cancer, 0:16:07.360 --> 0:16:09.720 if you're my oncologist and you haven't had my lung cancer, 0:16:09.880 --> 0:16:13.040 well I'm not going to go here. He's fantastic, and 0:16:13.120 --> 0:16:16.200 so he treated me with great respect and listen, I 0:16:16.280 --> 0:16:19.000 am an annoying human being. And I threw just a 0:16:19.040 --> 0:16:21.600 mountain of studies at him and then at his boss, 0:16:21.840 --> 0:16:24.480 who was then the head of Kaiser grond Ecology, and 0:16:24.640 --> 0:16:27.440 they actually met with me and listened and were persuaded 0:16:27.480 --> 0:16:30.880 by the evidence I provided, and so they covered the drug, 0:16:31.000 --> 0:16:33.240 gave me the amount I needed, which they'd taken France 0:16:33.280 --> 0:16:37.200 since nineteen eighty safely, you know. And as they said 0:16:37.200 --> 0:16:41.960 to me, well, that's not American you know research. I'm sorry, 0:16:42.040 --> 0:16:44.200 like our French woman in Martians or to think he's 0:16:44.280 --> 0:16:47.200 dressed better and eat better food, you know, I mean, 0:16:47.200 --> 0:16:51.680 it's crazy. So that gave me my sleep. What it 0:16:51.720 --> 0:16:55.280 also does to protect my bones, my cardiovascular system. And 0:16:55.320 --> 0:16:57.800 this is a huge thing I want to mention about menopause. 0:16:59.080 --> 0:17:02.080 We have this fraudulent research that came out around two 0:17:02.120 --> 0:17:05.680 thousand and two, the Women's Health Initiative study that basically said, 0:17:06.240 --> 0:17:07.840 you know, you're gonna get breast cancer your head. 0:17:09.000 --> 0:17:12.080 That's been I mean, I feel like I've read so 0:17:12.160 --> 0:17:16.800 many articles about how that's been disproven and that's just 0:17:16.960 --> 0:17:20.000 no longer considered the case in the medical world. 0:17:20.400 --> 0:17:24.240 It was methodological crap, and it was it was fraud 0:17:24.320 --> 0:17:27.760 basically because these researchers in two thousand and two, I mean, 0:17:27.760 --> 0:17:29.959 if you tell the true story, you know, or if 0:17:29.960 --> 0:17:33.040 you actually first of all do appropriate testing, you don't 0:17:33.040 --> 0:17:36.240 have women scared and you know, throwing their estrogen prescriptions 0:17:36.280 --> 0:17:39.960 in the toilet. What they said is that healthy menopausal 0:17:40.000 --> 0:17:44.080 women will get you know, breast cancer, Alzheimer's, et cetera. Well, wait, 0:17:44.080 --> 0:17:46.840 a second. The women in the study were like seventy 0:17:46.920 --> 0:17:51.159 nine years old, seventy five? You don't give does grandma 0:17:51.240 --> 0:17:54.320 going to the doctorate account of hormones? No? And the 0:17:54.400 --> 0:17:57.240 thing is what we know now, there's something called the timing. 0:17:58.119 --> 0:18:01.600 It's a critical window, the time hypothesis, and it's there's 0:18:01.640 --> 0:18:04.360 good evidence behind this that if you are a healthy 0:18:04.400 --> 0:18:07.280 woman you don't have plaque building up your arteries. You're not. 0:18:07.320 --> 0:18:11.000 You're healthy right at menopause and you start ester. Can 0:18:11.040 --> 0:18:14.800 you initiate it then then it will be health when protective? 0:18:15.080 --> 0:18:17.560 And what doctors said the head of Kaiser, the current 0:18:17.600 --> 0:18:21.560 head of Kaiser Gnecology, this is so appalling. My doctor, 0:18:21.560 --> 0:18:25.560 my excellent gynecologist who listens and considers the science is out, 0:18:25.880 --> 0:18:27.919 you know, and so till August. So I had to 0:18:27.920 --> 0:18:30.400 meet with her. She tells me you need to tape 0:18:30.400 --> 0:18:33.439 her off estrogen at sixty. I said like, oh, this 0:18:33.560 --> 0:18:37.399 is so so outdated and so disproven that even the 0:18:37.440 --> 0:18:41.040 menopause society they're always behind the times. In twenty twenty two, 0:18:41.400 --> 0:18:44.560 my point was like last three weeks ago in twenty 0:18:44.600 --> 0:18:46.280 to twenty two, they came out and there said there 0:18:46.359 --> 0:18:49.040 is no stopping rule. You know, it's to be decided 0:18:49.080 --> 0:18:52.000 on individual health. And the thing is people think, well 0:18:52.040 --> 0:18:54.719 I should get off estrogen. No, if you are, if 0:18:54.760 --> 0:18:56.760 you're healthy, it needs to be you need to be monitored. 0:18:57.000 --> 0:18:59.560 But if you're a healthy person, when you initiate it 0:18:59.800 --> 0:19:03.040 and you remain healthy and your monitor for that, what 0:19:03.080 --> 0:19:05.480 you want is to be taking estrogen when you're old, 0:19:05.880 --> 0:19:08.879 because when do we break bones at seventy nine? And 0:19:08.920 --> 0:19:10.200 we break them because we fall. 0:19:10.480 --> 0:19:13.640 There's stigma around talking about menopause. 0:19:14.480 --> 0:19:18.200 There's nausea, there's bleeding. None of it is very attractive, right, 0:19:18.600 --> 0:19:22.080 But there's also the sense that menopause means you're ancient 0:19:22.160 --> 0:19:24.560 and it's the end of the road. And you kind 0:19:24.560 --> 0:19:26.840 of turn that on its head in the book and 0:19:26.880 --> 0:19:30.840 say that it could be the start of your new 0:19:30.880 --> 0:19:33.320 life or your new path. What do you mean by that? 0:19:33.800 --> 0:19:37.200 Exactly? See, if you have your health, then you can 0:19:37.320 --> 0:19:38.960 just be you all your life and just be a 0:19:39.000 --> 0:19:41.600 little wrinkled, you know, and there are things that go wrong, 0:19:41.840 --> 0:19:45.000 but this is so important. I do not accept the 0:19:45.080 --> 0:19:48.439 stigma that we are less, you know when we age, 0:19:48.480 --> 0:19:50.399 And so I go around telling people, I mean I 0:19:50.520 --> 0:19:53.600 was shove it at them I'm sixty one, I'm sixty one. 0:19:53.680 --> 0:19:55.600 I'm sixty one because. 0:19:55.440 --> 0:19:57.640 I'm very I'm forty eight and I'm open about it 0:19:57.680 --> 0:19:59.800 and I don't care, and I'm never gonna lie about 0:19:59.800 --> 0:20:00.320 my age. 0:20:01.040 --> 0:20:03.479 And the thing is, I'm a better human being in 0:20:03.560 --> 0:20:07.880 every way, you know, except for my eyesight. Now it's 0:20:07.920 --> 0:20:12.080 sixty one than I ever was. I'm kinder, you know, 0:20:12.400 --> 0:20:15.560 my work is better. It's just wonderful to be this 0:20:15.720 --> 0:20:18.119 age and be the person I am now. And I 0:20:18.200 --> 0:20:21.840 see those so many women. Something happens at fifty women 0:20:23.040 --> 0:20:25.359 we have we tend to be, many of us timid 0:20:25.400 --> 0:20:28.680 in some ways, you know, And at fifty, so many 0:20:28.720 --> 0:20:32.520 women developed this confidence almost out of nowhere, where they 0:20:32.560 --> 0:20:36.400 will speak up, you know, pitch themselves, put themselves out there, 0:20:36.440 --> 0:20:39.040 stand up for things. And this is exciting, and you 0:20:39.080 --> 0:20:41.679 can even if that's not naturally occurring for you. The 0:20:41.760 --> 0:20:45.080 thing is, you know, our emotions and our way of being. 0:20:45.400 --> 0:20:47.919 This is not a mandate. You can choose to be 0:20:48.080 --> 0:20:50.639 that way, and you can choose to be this about 0:20:50.680 --> 0:20:54.000 age also to be this way. And the reason that 0:20:54.080 --> 0:20:56.760 it's it's important to do this is that we can 0:20:56.800 --> 0:21:01.280 have a whole like third or fourth act. And so 0:21:01.440 --> 0:21:03.800 my friend I'll give my friend w Levin as an example. 0:21:04.160 --> 0:21:07.199 She I met at the Alternative Weekly newspaper conferences. I 0:21:07.240 --> 0:21:10.000 was selling my syndicated column. She was selling John Callahan, 0:21:10.119 --> 0:21:14.119 the cartoonist, and she was She's an agent. She's really 0:21:14.160 --> 0:21:19.040 great at that. Well. She is now a pretty legendary ceramicist. 0:21:19.480 --> 0:21:22.320 She sells her work all over galleries, you know, the 0:21:22.760 --> 0:21:26.000 like designers. It's really sought after. And this just happened 0:21:26.000 --> 0:21:29.080 in a few years and she developed this and this 0:21:29.200 --> 0:21:31.560 is the way. And like a neighbor of mine, missus 0:21:31.600 --> 0:21:34.440 Abbot Kinney, she used to be on Twitter. She does 0:21:34.960 --> 0:21:38.560 literacy volunteering for adults, teaching adults to read at our 0:21:38.640 --> 0:21:41.239 library here in Venice. So you can volunteer, you can 0:21:41.280 --> 0:21:43.680 move to Portugal. You know, there's some of it you 0:21:43.760 --> 0:21:46.399 can do and you just have to decide. You know 0:21:46.440 --> 0:21:49.240 that that really I call it old is the new black. 0:21:49.560 --> 0:21:51.919 I'm old. I'm old. I say it. I'm old, and 0:21:51.960 --> 0:21:55.600 I'm fabulous. You know the thing you're old? Yes I am, 0:21:55.840 --> 0:21:56.320 I am. 0:21:57.600 --> 0:22:00.200 It gets me into my my one of my three 0:22:00.280 --> 0:22:02.200 questions that I ask all my guests, what do you 0:22:02.240 --> 0:22:02.840 worry about? 0:22:03.480 --> 0:22:05.639 Oh? My god? I worry that I've missed something, that 0:22:05.640 --> 0:22:07.960 I'm not getting the science right. I have such a 0:22:08.000 --> 0:22:12.960 responsibility to people, and so luckily this worry and the 0:22:13.080 --> 0:22:17.320 lack of you know, the sort of arrogance that comes 0:22:17.320 --> 0:22:21.639 with being formally educated, you know, has me looking at 0:22:21.680 --> 0:22:24.439 things and relooking at things and sending my workout to 0:22:24.480 --> 0:22:27.200 be fact checked. I tell people actually to like kick 0:22:27.240 --> 0:22:29.960 my ass, wipe the floor with me, because they don't 0:22:30.000 --> 0:22:32.360 believe you when you say you want criticism. But that's 0:22:32.440 --> 0:22:34.320 really important to me, and that is my terror. 0:22:34.960 --> 0:22:37.200 I love that we're going to take a quick break 0:22:37.200 --> 0:22:42.840 and be right back on the Carol Marcowitch Show. What 0:22:43.040 --> 0:22:46.080 advice would you give your sixteen year old self? Like, 0:22:46.080 --> 0:22:48.720 what did sixteen year old Amy not know that you 0:22:48.760 --> 0:22:49.440 wish she did. 0:22:49.920 --> 0:22:54.720